Children's Hospital Medical Center, Cincinnati, proposes an exploratory research center in juvenile rheumatic disease aimed at developing the resources and collaborative relationships needed for establishing a research center under the Multipurpose Arthritic and Musculoskeletal Disease Center (MAMDC) program. The exploratory center will have two major research components: (1) education, epidemiology, and health services research (EEHSR); and (2) biomedical studies (BIOMED). This comprehensive program will advance new applied clinical research and promote innovative approaches to laboratory investigations in the field of juvenile rheumatic disease. The EEHSR component proposes two pilot projects: (1) Long-term disease outcome among patients with juvenile rheumatoid arthritis (JRA); and (2) Bone mineralization in JRA. The BIOMED component proposes three additional pilot projects: (3) Tumor necrosis factor in JRA; (4) The role of superantigen in Kawasaki's disease; and (5) Application of human genome methodology to JRA. Eight additional developmental and feasibility studies described in this proposal may be either activated during the proposed funded period or incorporated into an evolving MAMDC application. An Administrative and Planning Core will provide support services and executive leadership to the pilot projects and to the developing MAMDC through a number of subcores and resources: (1) Executive- Administrative-Planning Subcore; (2) Epidemiology-Biostatistical-Databank Subcore; (3) Patient Assessment Subcore; (4) Tissue Bank Resource; and (5) Molecular and Cellular Immunology Laboratory Resource. Through the proposed funded period an Executive and Planning Committee will develop an application to be submitted to the NIH under the MAMDC program.